胰腺钩突部癌的外科手术治疗  

Surgical treatment for uncinate process carcinoma of the pancreas

作　　者：李森[1] 裴永泉[1] 杜福田[1] 宋钦华[1] 庄冠一[1] 李春友[1] 王建立[1] 

机构地区：[1]山东省潍坊市人民医院肝胆外科,261041

出　　处：《中华普通外科杂志》2001年第3期133-135,共3页Chinese Journal of General Surgery

摘　　要：目的　总结胰腺钩突部癌的临床特点及提高手术切除率的措施。方法　 1990年 1月至 1999年 6月 ,我院对 10例胰腺钩突部癌行胰十二指肠切除术 ,其中 7例联合门静脉 (PV)和肠系膜上静脉 (SMV)切除 ,有 5例切除静脉干长度为 2 0～ 4 2cm ,直接对端吻合成功 ;有 2例行受浸润血管侧壁切除修补术。门静脉阻断时间为 8～ 40min ,未同时阻断肠系膜上动脉。结果　联合PV、SMV切除的 7例中 ,有 1例术后 3d因肝功能衰竭死亡 ,1例术后出现乳糜样腹水 ,5例术后生存 13～ 2 9个月 ;未联合静脉切除的 3例中 ,有 2例分别存活 13个月和 14个月 ,有 1例已存活 11 5个月。结论　胰腺钩突部癌常侵犯邻近血管 ,对门静脉受侵犯者仍有可能行根治手术。Objective To summarize the clinical features of uncinate process carcinoma of the pancreas and improve the resection rate. Methods From Jan. 1990 to Jun.1999, Ten cases of pancreas uncinate process carcinoma received Whipple′s procedure. Portal vein resection and reanastomosis was performed in 5 cases, among them the resected length varied between 20～42 *!cm.Two cases underwent PV lateral wall partial resection. The longest time of PV blood occlusion was 40 *!minutes.Results Among 7 cases undergoing PV resection, 1 died with hepatic failure 3 days post-op. 1 case suffered postoperative chylous ascites.These 6 cases survived 13 to 29 months post-op. Among 3 cases not undergoing PV resection, 2 cases survived 13 months and 14 months, respectively. 1 case is still alive at the follow-up of 115 months post-op. Conclusion Pancreas uncinate process carcinoma has the tendency of invading adjacent PV and SMV, which should not be simply regarded as a contraindication of the radical resection.

关 键 词：胰腺钩突部癌 胰头十二指肠切除术 手术切除率 疗效 

分 类 号：R735.9[医药卫生—肿瘤] R730.56[医药卫生—临床医学]